pelvic organ prolapse; prolapse surgery trends; surgical management; vaginal mesh
Résumé :
[en] Management of pelvic organ prolapse (POP) may
be conducted by abdominal (laparotomy or laparoscopy) or
vaginal approach, with or without mesh repair, mainly depending
on the surgeon’s expertise. The aim of this study
was to determine the trends in surgical management of POP
in French-speaking Belgium. The GGOLFB Gynecologic surgery
working group initiated a registry of the patients surgically
treated for POP from eight centers in French-speaking
Belgium. In this prospective multicentric study, conducted
between June 2010 and January 2013, we analyzed the clinical
and surgical data, the postoperative results at 4 months, the
intra and postoperative complications, and reoperation rates.
A total of 394 patients were registered in the database.
Surgical POP repair was performed vaginally in 83.5 % of
the patients, with prosthetic material in 70.2 % of the cases.
In case of abdominal procedure, surgery was mainly (93.5 %)
performed by laparoscopic sacrocolpopexy. The most common
intraoperative complications were severe bleeding
(2.3 %), bladder (2 %), and bowel (0.2 %) injuries. At
4 months, the total reoperation rate was 11.3 %. The anatomical
success rate (POP-Q < 2) was 87.5 % with 2.1 % of
reoperation for recurrence. Mesh exposure was observed in
9.8 % of the cases. Surgery for stress urinary incontinence
(SUI) was reported in 5.1 % of the patients. The analysis of
the current urogynecological practice in French-speaking
Belgium shows that vaginal mesh repair is the preferential
approach used for management of POP in the participating
centers. The creation of a national database will help to evaluate
the global trends in prolapse surgery and the potential
impact of the FDA notification in the management of POP
in Belgium.
Disciplines :
Médecine de la reproduction (Gynécologie, andrologie, obstétrique)
Auteur, co-auteur :
DE LANDSHEERE, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > Service de gynécologie-obstétrique (CHR)
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